Which step is appropriate when a postpartum patient has a fever of 38.3 C?

• A. Immediately administer broad-spectrum antibiotics without assessment
• B. Reassess in 24 hours
• C. Initiate infection workup including CBC and cultures
• D. Schedule follow-up in a week

Answer: (C)

When a postpartum patient develops a fever, the priority is to quickly identify the source of infection and assess for potential sepsis. The best next step is to initiate an infection workup that includes a CBC and cultures. A CBC helps gauge the inflammatory response (for example, leukocytosis common with infection), while cultures (urine, blood, and any wound cultures as indicated) help pinpoint the source and guide targeted antimicrobial therapy. Jumping straight to broad-spectrum antibiotics without first evaluating and identifying the source risks inappropriate treatment and delays pinpointing the cause. Delaying assessment or following up days later isn’t appropriate because postpartum infections can progress rapidly, so immediate evaluation is warranted. If signs of sepsis or instability are present, treat promptly while the workup is underway.